The Graston Technique® is a modification of traditional hands-on soft tissue mobilization that uses specifically designed instruments to allow the therapist to introduce a controlled amount of microtrauma into an area of excessive scar and/or soft tissue fibrosis. The hope is that this will invoke an inflammatory response that will augment the healing process. It is also intended to reduce the stress on the therapist’s hands.
Microtrauma? Hurting people to make them better? I know sometimes an improperly healed bone must be re-broken so it can re-heal in proper alignment, but this is different. It bothers me that they are further injuring already damaged soft tissues and hoping (1) that the new injury will heal, (2) that that will help the older injury heal, and (3) that it can somehow avoid stimulating the deposition of just that much more scar tissue and fibrosis.
For instance, Graston is often recommended for a kind of knee tendonitis, IT band syndrome. Even if ilitobial band syndrome really is caused by fibrosis/adhesions — which is not a safe assumption — it seems like Graston technique might be just as likely to make it worse as better!
Graston seems to violate the “primum non nocere” principle. It is unpalatable. Of course that wouldn’t matter if the evidence showed it was effective. Does it? (more…)